Ecology of African Highland Malaria

项目摘要 非洲高原疟疾（英语：Ecology of African Highland Malaria） 在过去十年中，经杀虫剂处理过的蚊帐和室内残留杀虫剂的使用量大幅度增加， 喷洒（IRS）以及采用青蒿素综合疗法， 非洲高原疟疾流行率和发病率大幅下降。但是，在这方面， 杀虫剂抗药性的上升和户外传播的增加极大地阻碍了 驱虫蚊帐和室内滞留喷洒的有效性，因为目前的室内干预措施没有针对 在户外叮咬的蚊子因此，大多数高原地区保持着持续的低- 一些国家的疟疾发病率最近有所上升，但其他一些国家的疟疾发病率最近有所上升。 因此，新的补充干预措施，可以解决户外传播， 对拟除虫菊酯杀虫剂的抗药性是迫切需要的。其核心目标是 竞争性续期申请的目的是确定 EPA批准的长效微生物杀幼虫剂在减少疟疾传播和 肯尼亚西部高地的疟疾临床发病率。三个具体目标是：1） 研究调节幼虫栖息地生产力的机制，2）确定 长效微生物杀幼虫剂对减少疟疾传播和临床疟疾的作用 采用整群随机研究确定发病率; 3）确定 与其他疟疾控制干预措施相比， 并评估其对非靶生物的影响。通过综合评价， 潜在的具有成本效益的长效微生物杀幼虫剂，该项目将提供关键的 需要关于长效微生物杀幼虫剂是否可以作为补充扩大规模的数据 疟疾控制工具，以进一步降低非洲高地的疟疾发病率。疟疾户外 传播控制目前是疟疾中非常重要和紧迫的问题 因此，我们的结果将对疟疾产生广泛的影响 非洲地方病和流行病地区的预防和控制。

PROJECT SUMMARY Title: Ecology of African Highland Malaria In the past decade, massive scale-up of insecticide-treated nets (ITN) and indoor residual spraying (IRS), together with the introduction of artemisinin-combination treatments, have led to substantial reductions in malaria prevalence and incidence in African highlands. However, rising insecticide resistance and increased outdoor transmission have greatly hampered the effectiveness of ITN and IRS because the current indoor-based interventions do not target the outdoor-biting mosquitoes. Consequently, most highland sites maintain sustained low- level transmission while some others have recently experienced resurgence in malaria rates. Therefore, new supplemental interventions that can tackle outdoor transmission and pyrethroid insecticide resistance are urgently needed. The central objective of this competing renewal application is to determine the efficacy and cost-effectiveness of EPA-approved long-lasting microbial larvicides in reducing malaria transmission and clinical malaria incidence in western Kenya highlands. The three specific aims are: 1) to examine mechanisms regulating larval habitat productivity, 2) to determine the efficacy of long-lasting microbial larvicides on the reduction of malaria transmission and clinical malaria incidence using a cluster randomized study, and 3) to determine the cost-effectiveness of the long-lasting microbial larviciding program as compared to other malaria control interventions and evaluate its impact on non-target organisms. Through comprehensive evaluation of potentially cost-effective long-lasting microbial larvicides, this project will provide critically needed data on whether long-lasting microbial larvicides can be scaled up as a supplemental malaria control tool to further reduce malaria incidence in African highlands. Malaria outdoor transmission control is presently a highly significant and urgent issue in malaria control across Africa, and thus, our results will have broad implications on malaria prevention and control in endemic and epidemic regions of Africa.